title: Survey of H2-antagonist usage in acute upper gastrointestinal hemorrhage.
abstract: H2-antagonists are frequently used in the management of upper gastrointestinal (UGI) hemorrhage despite their lack of proven efficacy. In order to determine the pattern of H2-antagonist usage for this indication, we retrospectively reviewed the charts of 137 patients admitted with acute UGI bleeding over a 1-year period at two teaching hospitals in West Texas. An H2-antagonist was ordered in 89% of patients (77%) intravenous, 12% oral). It was administered within 2 h of admission in 25% of these patients, within 4 h in 54%, and within 8 h in 78%. An H2-antagonist was ordered among the initial six orders in 49% and among the initial 10 orders in 77% of patients. Considering orders for specific therapies, an H2-antagonist was in the initial three orders in 60% of patients and among the initial six orders in 97%. Of the patients who were prescribed an H2-antagonist and who also had upper endoscopy, the drug was ordered prior to endoscopy in 86%. This review of H2-antagonist usage in the management of acute UGI bleeding has identified a prescribing pattern of writing for these drugs early in the sequence of order writing, with the drugs being given early in the course of hospitalization.
authors.affiliation: Department of Medicine, Texas Tech University Health Sciences Center, El Paso 79905.
authors.forename: B D
authors.initials: BD
authors.lastname: Bhatt
authors.forename: F V
authors.initials: FV
authors.lastname: Meriano
authors.forename: T L
authors.initials: TL
authors.lastname: Phipps
authors.forename: H
authors.initials: H
authors.lastname: Ho
authors.forename: M J
authors.initials: MJ
authors.lastname: Zuckerman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002927:Cimetidine / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011899:Ranitidine / Q000627:therapeutic use*
chemical_list: D002927:Cimetidine; D011899:Ranitidine